卵巢癌与宫颈癌合并血栓栓塞性疾病临床特点分析

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目的:对比分析上皮性卵巢癌患者与宫颈鳞状细胞癌患者发生静脉血栓栓塞(VTE)的临床特征,分析其高危因素,为其临床预防及诊治提供参考。方法:回顾性分析我院收治的上皮性卵巢癌患者(n=147例)及宫颈鳞状细胞癌患者(n=149例)的临床资料,对比分析两组患者VTE发生临床特点的差异,尤其是化疗及围手术期对VTE发生的影响,单因素回归分析VTE发生的高危因素。结果:卵巢癌患者的VTE发生率高于宫颈癌患者(13.6%vs 7.4%,P=0.08),但无统计学意义。卵巢癌患者与宫颈癌患者VTE的发生具有不同特点,卵巢癌患者VTE多发生于初步诊断时(65% vs 9.1%,P=0.003),而宫颈癌患者VTE多发生于手术后(81.8%vs 25%,P=0.006)。两组患者新辅助化疗期间VTE发生率(10% vs 0%,P=0.53)以及术后辅助化疗期间VTE发生率(0%vs 9.1%,P=0.354)均无显著差异。多数患者合并的VTE均为下肢静脉血栓,仅1例卵巢癌患者发生肺栓塞。单因素分析发现卵巢癌患者绝经后状态(17.9% vs 5.8%,P=0.045)为VTE发生的高危因素。结论:卵巢癌患者与宫颈癌患者VTE发生特点存在显著差异。卵巢癌患者易自发发生VTE,宫颈癌患者VTE多于手术后发生。卵巢癌患者与宫颈癌患者合并VTE的总发病率无统计学差异。化疗不增加两组患者VTE的发生率。 Objective: To compare and analyze the clinical features of venous thromboembolism (VTE) in patients with epithelial ovarian cancer and squamous cell carcinoma of the cervix, analyze the risk factors and provide reference for its clinical prevention and treatment. Methods: The clinical data of patients with epithelial ovarian cancer (n = 147) and cervical squamous cell carcinoma (n = 149) admitted to our hospital were retrospectively analyzed. The clinical features of VTE in the two groups were compared and analyzed, especially Chemotherapy and perioperative period on the impact of VTE, univariate regression analysis of risk factors for the occurrence of VTE. Results: The incidence of VTE in ovarian cancer patients was higher than that in cervical cancer patients (13.6% vs 7.4%, P = 0.08), but not statistically significant. The occurrence of VTE in ovarian cancer patients and cervical cancer patients has different characteristics. The incidence of VTE in patients with ovarian cancer mostly occurred in the initial diagnosis (65% vs 9.1%, P = 0.003), while the incidence of VTE in patients with cervical cancer mostly occurred after surgery (81.8% vs 25%, P = 0.006). The incidence of VTE during neoadjuvant chemotherapy (10% vs 0%, P = 0.53) and VTE during postoperative adjuvant chemotherapy (0% vs 9.1%, P = 0.354) did not differ significantly between the two groups. VTE was found in most patients with venous thrombi in the lower extremities, and pulmonary embolism occurred in only 1 patient with ovarian cancer. Univariate analysis found that the postmenopausal status of ovarian cancer patients (17.9% vs 5.8%, P = 0.045) was a risk factor for VTE. Conclusion: The characteristics of VTE in patients with ovarian cancer and cervical cancer have significant differences. Patients with ovarian cancer prone to spontaneous VTE, cervical cancer patients with VTE occurred more than after surgery. There was no significant difference in the overall incidence of VTE between ovarian cancer patients and cervical cancer patients. Chemotherapy did not increase the incidence of VTE in both groups.
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